PURPOSE: Renal ultrasonography has been widely used in children with renal disease. However, the relationship of renal echogenicity with renal pathology and function in children is not well known. METHODS: Ultrasound examination was performed in 75 patients undergoing renal biopsy for suspected renal disease in Konkuk University Medical Center from August 2005 to November 2015. We compared renal echogenicity to pathologic findings and renal function. Renal echogenicity was scored as 0 to 2 by comparing adjacent liver echogenicity. Three histologic characteristics were evaluated: glomerular changes, interstitial infiltration or fibrosis, and tubular atrophy. These were graded as 0 to 3, according to increasing severity. Laboratory results included urine albumin excretion and estimated glomerular filtration rate (eGFR). RESULTS: Among pathologic findings, renal echogenicity revealed a positive correlation with interstitial infiltration or fibrosis (r=0.259, P=0.025), and with tubular atrophy (r=0.268, P=0.02). Renal echogenicity and glomerular changes were not correlated. Renal echogenicity showed a positive correlation with microalbuminuria (r=0.283, P=0.014), but a negative correlation with eGFR (r=-0.352, P=0.002). CONCLUSION: Increased renal echogenicity suggested severe interstitial infiltration or fibrosis and tubular atrophy among the pathologic findings. Moreover, increased echogenicity is correlated with increased urine albumin excretion and decreased eGFR. Echogenicity on ultrasonography is useful for determining the status of renal pathology and function.
Academic Medical Centers ; Albuminuria ; Atrophy ; Biopsy ; Child ; Fibrosis ; Glomerular Filtration Rate ; Humans ; Liver ; Pathology* ; Ultrasonography

PURPOSE: Renal ultrasonography has been widely used in children with renal disease. However, the relationship of renal echogenicity with renal pathology and function in children is not well known. METHODS: Ultrasound examination was performed in 75 patients undergoing renal biopsy for suspected renal disease in Konkuk University Medical Center from August 2005 to November 2015. We compared renal echogenicity to pathologic findings and renal function. Renal echogenicity was scored as 0 to 2 by comparing adjacent liver echogenicity. Three histologic characteristics were evaluated: glomerular changes, interstitial infiltration or fibrosis, and tubular atrophy. These were graded as 0 to 3, according to increasing severity. Laboratory results included urine albumin excretion and estimated glomerular filtration rate (eGFR). RESULTS: Among pathologic findings, renal echogenicity revealed a positive correlation with interstitial infiltration or fibrosis (r=0.259, P=0.025), and with tubular atrophy (r=0.268, P=0.02). Renal echogenicity and glomerular changes were not correlated. Renal echogenicity showed a positive correlation with microalbuminuria (r=0.283, P=0.014), but a negative correlation with eGFR (r=-0.352, P=0.002). CONCLUSION: Increased renal echogenicity suggested severe interstitial infiltration or fibrosis and tubular atrophy among the pathologic findings. Moreover, increased echogenicity is correlated with increased urine albumin excretion and decreased eGFR. Echogenicity on ultrasonography is useful for determining the status of renal pathology and function.
Academic Medical Centers ; Albuminuria ; Atrophy ; Biopsy ; Child ; Fibrosis ; Glomerular Filtration Rate ; Humans ; Liver ; Pathology* ; Ultrasonography

PURPOSE: The optimal perioperative treatment for resectable esophageal squamous cell carcinoma (ESCC) remains controversial. We evaluated the efficacy and safety of leucovorin and 5-fluorouracil (LV5FU2) and LV5FU2 plus oxaliplatin (FOLFOX) combination chemotherapies administered adjuvantly for curatively-resected, node-positive ESCC. MATERIALS AND METHODS: Patients with pathologically node-positive esophageal cancer after curative R0 resection were enrolled and randomly assigned to receive LV5FU2 or FOLFOX biweekly for up to eight cycles. The primary endpoint was disease-free survival (DFS). RESULTS: Between 2011 and 2015, 62 patients were randomized into the two treatment groups (32 in the LV5FU2 arm and 30 in the FOLFOX arm). The median age was 60 years and both groups had similar pathologic characteristics in tumor, nodal status, and location. Treatment completion rates were similarly high in both groups. The DFS rate at 12 months was 67% in the LV5FU2 group and 63% in the FOLFOX group with a hazard ratio of 1.3 (95% confidence interval [CI], 0.66 to 2.62). After a median follow-up period of 27 months, the median DFS was 29.6 months (95% CI, 4.9 to 54.2) in the LV5FU2 arm and 16.8 months (95% CI, 7.5 to 26.1) in the FOLFOX arm (p=0.428), respectively, while the median overall survival was not reached in either arm. Grade 3 or 4 neutropenia was more frequent in patients in the FOLFOX arm than the LV5FU2 arm (20.0% vs. 3.1%). CONCLUSION: The addition of oxaliplatin (FOLFOX) did not lead to better efficacy compared to LV5FU2 chemotherapy in an adjuvant setting in node-positive ESCC patients.
Arm ; Carcinoma, Squamous Cell* ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Drug Therapy ; Drug Therapy, Combination ; Epithelial Cells* ; Esophageal Neoplasms ; Fluorouracil ; Follow-Up Studies ; Humans ; Leucovorin ; Neutropenia

PURPOSE: The optimal perioperative treatment for resectable esophageal squamous cell carcinoma (ESCC) remains controversial. We evaluated the efficacy and safety of leucovorin and 5-fluorouracil (LV5FU2) and LV5FU2 plus oxaliplatin (FOLFOX) combination chemotherapies administered adjuvantly for curatively-resected, node-positive ESCC. MATERIALS AND METHODS: Patients with pathologically node-positive esophageal cancer after curative R0 resection were enrolled and randomly assigned to receive LV5FU2 or FOLFOX biweekly for up to eight cycles. The primary endpoint was disease-free survival (DFS). RESULTS: Between 2011 and 2015, 62 patients were randomized into the two treatment groups (32 in the LV5FU2 arm and 30 in the FOLFOX arm). The median age was 60 years and both groups had similar pathologic characteristics in tumor, nodal status, and location. Treatment completion rates were similarly high in both groups. The DFS rate at 12 months was 67% in the LV5FU2 group and 63% in the FOLFOX group with a hazard ratio of 1.3 (95% confidence interval [CI], 0.66 to 2.62). After a median follow-up period of 27 months, the median DFS was 29.6 months (95% CI, 4.9 to 54.2) in the LV5FU2 arm and 16.8 months (95% CI, 7.5 to 26.1) in the FOLFOX arm (p=0.428), respectively, while the median overall survival was not reached in either arm. Grade 3 or 4 neutropenia was more frequent in patients in the FOLFOX arm than the LV5FU2 arm (20.0% vs. 3.1%). CONCLUSION: The addition of oxaliplatin (FOLFOX) did not lead to better efficacy compared to LV5FU2 chemotherapy in an adjuvant setting in node-positive ESCC patients.
Arm ; Carcinoma, Squamous Cell* ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Drug Therapy ; Drug Therapy, Combination ; Epithelial Cells* ; Esophageal Neoplasms ; Fluorouracil ; Follow-Up Studies ; Humans ; Leucovorin ; Neutropenia

Plasma pH can be altered during pregnancy and at labor. Membrane excitability of smooth muscle including uterine muscle is suppressed by the activation of K+ channels. Because contractility of uterine muscle is regulated by extracellular pH and humoral factors, K+ conductance could be connected to factors regulating uterine contractility during pregnancy. Here, we showed that TASK-2 inhibitors such as quinidine, lidocaine, and extracellular acidosis produced contraction in uterine circular muscle of mouse. Furthermore, contractility was significantly increased in pregnant uterine circular muscle than that of non-pregnant muscle. These patterns were not changed even in the presence of tetraetylammonium (TEA) and 4-aminopyridine (4-AP). Finally, TASK-2 inhibitors induced strong myometrial contraction even in the presence of L-methionine, a known inhibitor of stretchactivated channels in myometrium. When compared to non-pregnant myometrium, pregnant myometrium showed increased immunohistochemical expression of TASK-2. Therefore, TASK-2, seems to play a key role during regulation of myometrial contractility in the pregnancy and provides new insight into preventing preterm delivery.
4-Aminopyridine ; Acidosis ; Animals ; Contracts ; Female ; Hydrogen-Ion Concentration ; Lidocaine ; Membranes ; Methionine ; Mice ; Muscle, Smooth ; Muscles ; Myometrium ; Plasma ; Pregnancy ; Quinidine ; Relaxation ; Uterine Contraction ; Uterus

The authors report a case of renal cell carcinoma in a right malrotated (horizontal axis) kidney. The patient was treated by hand-assisted laparoscopic radical nephrectomy. This is the first report of a horizontal axis malrotated kidney with renal cell carcinoma.
Axis, Cervical Vertebra ; Carcinoma, Renal Cell ; Humans ; Kidney ; Nephrectomy

PURPOSE: Laparoscopic radical nephrectomy is a standard treatment for localized renal cell carcinoma. Although it is less invasiveness than open surgery, it has a steeper learning curve compared with open surgery. We analyzed the results of laparosopic radical nephrectomy that was performed by 3 surgeons who had finished a 1-year laparoscopy educational program. MATERIALS AND METHODS: A total of 103 cases of laparoscopic radical nephrectomy that were performed from June 2003 to July 2007 were enrolled in this study. These cases were performed via a transperitoneal, pure laparoscopic approach. We analyzed each surgeon's operative time, their operative blood loss and the complication rate, and then we examined a sequential transition after dividing the cases into three groups. RESULTS: The average tumor size was 4.69+/-2.21cm. The tumor stage distribution was T1 in 74 cases, T2 in 14 cases, T3a in 13 cases and T3b in 2 cases. The average operative time and calculated operative blood loss were 211.6+/-73.4 min and 553.6+/-466.9ml, respectively. Intraoperative complications occurred in 13 cases(12.6%). There were 2 cases of open conversion due to vascular injury. Surgeon A did a total of 50 cases during 4 years and his average operative time and estimated blood loss 170.8+/- 61.7 min and 577.4+/-457.5ml, respectively. Surgeon B did a total of 29 cases during 3 years and his results were 259+/-74.8 min and 434.8+/-468.1ml, respectively. Surgeon C did 24 cases during 2 years and his results were 239.1+/-45.5 min and 604.3+/-489.7ml, respectively. Sequential analysis of each surgeon's data after dividing the cases into three groups showed that operative time decreased significantly for surgeons A & B. However, the operative blood loss and complication rates did not significantly differ. CONCLUSIONS: This intensified 1-year educational program was successful enough to allow an inexperienced surgeon to complete laparoscopic radical nephrectomy without supervision.
Carcinoma, Renal Cell ; Intraoperative Complications ; Laparoscopy ; Learning Curve ; Nephrectomy ; Operative Time ; Vascular System Injuries

OBJECTIVE: The aim of this study is to verify the clinical outcome of staging surgery with and (or) without bilateral salpingo-oophorectomy (BSO) in clinical stage I-II endometrial cancer patients. METHODS: We reviewed the medical records of 178 surgically treated patients in clinical stage I-II endometrial cancer between January 1994 and December 2004. Overall survival (OS) and disease free survival (DFS) were analyzed by using data gathered from the National Statistics Office. The clinical outcome was compared between patients who underwent hysterectomy with and without BSO. RESULTS: One hundred sixty patients were in clinical stage I, and 18 patients were in clinical stage II. Most of the cases showed endometrioid (93.8%) in histology and G1 (56.1%) in differentiation. BSO was performed in 142 patients. Surgico-pathological features of two group are not different but the group without BSO were younger (40.7 vs. 55.8 years old) and less myometrial invasion than the group with BSO. After mean 39.27 months follow up, we found no difference in OS and DFS between the two groups with BSO and without BSO. No factors except stage were significantly related with OS and DFS by multivariate Cox regression analysis. The rate of pelvic and paraaortic lymph node metastasis was not different between two groups. CONCLUSION: The retrospective data in the study reveals that staging surgery with and without BSO does not affect OS and DFS in clinical stage I-II endometrial cancer patients. In limited cases, such as young women, omitting BSO can be considered carefully.
Disease-Free Survival ; Endometrial Neoplasms* ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Lymph Nodes ; Medical Records ; Neoplasm Metastasis ; Retrospective Studies

PURPOSE: This retrospective study was performed to investigate epidemiological characteristics in terms of the ageand the sex-specific incidences in patients with perforated or nonperforated appendicitis. METHOD: The study population comprised 314 patients who underwent appendectomies for suspected acute appendicitis between March 2002 and August 2003. This study used the student t-test, the coefficient of correlation, and the Cochran-Mantel-Haenszel Chi-square statistics. RESULTS: The incidence of nonperforated appendicitis was higher. Perforated appendicitis occurred at almost the same incidence in both sexes. However, the incidence of perforated appendicitis was high in small children and the elderly. The statistics of this study proved that the incidence of perforated appendicitis of the elderly was considerable. CONCLUSIONS: We suggest that the elderly need careful examination and rapid evaluation. Also, we suggest that since perforated appendicitis has a long duration of treatment, diagnostic accuracy is needed.
Aged ; Appendectomy ; Appendicitis* ; Child ; Humans ; Incidence* ; Retrospective Studies

Between 1989 and 1993, 31 patients who had undergone ACL reconstruction using autogenous patellar bone-tendon-bone were studied to evaluate the effects on knee joint function. After having harvested the central one third of the patellar tendon, it was positioned isometrically through tunnels of tibia and femur and also central defect of the patellar ligament was sutured loosely. Clinically Hospital for special surgery(HSS) knee socre by Marshall 1997, manual knee test, knee extention and flexion angles, Cybex test, KT-2000 measurments and radiological study were performed for subjective and objective symptoms at the average follow-up 33 months (range 18-72 months). Quadriceps weakness of strength less than 80% of the normal side was present in 61% of patients, patellofemoral joint pain in 15%, AP translation more than 3mm in 23%, flexion contracture of 5 degree or more in 29%. Hospital for special surgery(HSS) knee score was improved from 35 to 46 in average during follow-up period. The height of the patella was increased in 2 cases and decreased in 6 cases within normal variation which was not significant statistically. The above results indicate that importance of postoperative rehabilitation program and extension position of knee joint after surgery place a major emphasis on the avoidance of flexion contracture and on the improvement of joint function.
Contracture ; Femur ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Knee ; Patella ; Patellar Ligament ; Patellofemoral Joint ; Rehabilitation ; Tibia ; Transplants